Thursday, May 30, 2013

Will Life Ever Feel Normal Again?

About two months ago, I went in for my annual ob-gyn check-up. My doctor, Mindy Goldman, a professor at University of California San Francisco, has made a research specialty of exploring the problems that breast cancer survivors have. Dr. Goldman checks in on many levels: family, work, sex, social life, energy level, medication side effects.

At my appointment, when I complained about how difficult it is to reclaim your life—all of your life, sex, work, friends, energy—after cancer. Dr. Goldman asked, “How long since you finished active treatment?”

“About two years,” I replied.

“Well,” she said. “That sounds about right. I’ve observed that it usually takes a couple years before cancer survivors start to feel normal again. It takes a long time to feel like you’ve got your life back. Now’s about the right time to start working on your relationship with your husband, if you feel there’s room for improvement there.”

On the outside, I nodded dutifully and listened to her advice about how to get my romantic life back on track. But on the inside, this was my internal dialog: “What?!! Two years?! Why didn’t anyone tell me it would take that long? Why does everyone talk about post-treatment depression, work re-entry anxiety and all those things, but not the fact that it might take two years to feel normal again?!!”

In my medical team’s defense, I suppose they don’t tell patients this because everyone is different: Nancy Brinker, who started the Susan G. Komen Foundation in memory of her sister who died of breast cancer in her mid-30s, seemed to have barely skipped a beat when she herself got breast cancer. She didn’t stop working, or traveling, or going to social functions. Most patients, I think, cannot live up to this standard and take time out during treatment. Some feel pretty normal after a year. Some might take two years. Yet others might battle chronic treatment side effects and never feel quite normal again.

I wish the docs would let us know about this variation, yet tell us that normalcy takes a long time, longer than we might expect. I think this might help a lot of patients, and a lot of patients’ spouses, and a lot of patients’ families, to relax a little.

We need to know to give things time. At first, I thought I would have to just get through a couple months of depression after radiation ended. I battled through that, but then I had to face crippling stage fright about working again. Good writing, I think, comes from both reflection and a kind of extreme honesty. That’s hard to pull off when you feel you’ve been in Cancerland for more than a year while the world busily moved on. It’s hard to express yourself properly when the chemo brain still befuddles. Once I started working, I had to cope with lingering fatigue. It’s only been about six months since I stopped taking naps pretty regularly during my workday. Then, once I was working, socializing, exercising with a reasonable amount of energy, I took an honest look at my endlessly supportive and understanding husband and realized that the poor guy was not only suffering from his own kind of cancer PTSD, he’d been rather neglected since my diagnosis. So much had been about me. What about him?

We need to have the patience to let things unfold. Lord knows that cancer is about loss of control. I don’t know about you, but that doesn’t mean my control freak tendencies have completely disappeared. As a survivor, it’s when I’ve relaxed, when I’ve stopped trying to manage and control everything, that things have gotten better. This has been true not only for me, but for my husband and my family.

We also need to accept that normalcy does not mean that things will go back to exactly the way they were. I think my 12-year-old daughter will always have a vulnerable place that’s related to my cancer. She doesn’t want to talk about those fears and feelings yet, but I know they’re there. The left breast where I had my lumpectomy is partially numb; I just have to accept that. My husband has become a little tentative at times. Post-cancer, he has to fight the fear of being too demanding. None of these things are exactly optimal, but neither are they a bar to happiness.

As I write this, it is now two years and six months since I finished active treatment. I am just starting to feel normal again. My marriage is just beginning to feel normal again. I wish someone had told us it might take this long.

If normalcy is taking a while for you and your family, or for you and your spouse, don’t despair. It takes a long time. Hang in there.

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Contributors

Wendy Baer, MD

Wendy Baer, MD, is the medical director of psychiatric oncology at the Winship Cancer Institute of Emory University in Atlanta. Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and going through treatment. Her expertise in treating clinical depression and anxiety helps people manage emotions, behaviors and relationships during difficult times.

Heather Millar

Heather Millar is an award-winning freelance writer and author. In her blog My Left Breast, she details her treatment for breast cancer as well as the science, history, and ethics of the disease.